RT Journal Article SR Electronic T1 Systemic Review and Meta-analysis of Impact of Splenectomy for Advanced Gastric Cancer JF In Vivo JO In Vivo FD International Institute of Anticancer Research SP 3115 OP 3125 DO 10.21873/invivo.12145 VO 34 IS 6 A1 CHIKARA KUNISAKI A1 SHO SATO A1 NOBUHIRO TSUCHIYA A1 JUN WATANABE A1 TSUTOMU SATO A1 KAZUHISA TAKEDA A1 KOHEI KASAHARA A1 TAKASHI KOSAKA A1 HIROTOSHI AKIYAMA A1 ITARU ENDO A1 TOSHIHIRO MISUMI YR 2020 UL http://iv.iiarjournals.org/content/34/6/3115.abstract AB Background/Aim: Prophylactic splenectomy has shown no inferiority for tumors not invading the greater curvature side. Despite this, the clinical impact of prophylactic splenectomy for proximal advanced gastric cancer is not clear. This review aimed to clarify the impact of splenectomy for advanced gastric cancer in the upper third of the stomach. Materials and Methods: A systematic review and meta-analysis were conducted based on PubMed and EMBASE databases. The following search terms were used: “gastric cancer” OR “splenectomy” OR upper third of the stomach” OR preservation of the spleen. Results: Out of 765 articles, 18 studies (combined n=6,341) were included in the analysis. Four randomized controlled trials (RCT) and eight retrospective studies suggested the benefits of spleen-preserving gastrectomy. Six retrospective studies showed no significant benefit of spleen-preserving gastrectomy. Prophylactic splenectomy showed a close association with a higher incidence of postoperative morbidity (pancreatic fistula and anastomotic leakage) with no concomitant improvement in overall survival. Prophylactic splenectomy should not be routinely performed and RCTs are necessary to confirm the impact of splenectomy for cN(+) at the splenic hilum tumors and tumors invading the greater curvature.